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IEAC Legislative Update
IEAC Legislative Update The IEAC is pleased to announce a new feature in
its newsletter. The Legislative Update, which is included as an insert to this edition,
will appear in the IEAC Newsletter two times per year, and includes information
about immunization-related legislation which has been introduced at the state
level. Although the IEAC does not take engage in lobbying and/or legislative
activities, we want to provide you with sufficient information about the issues
which impact you.
This is legislation which was introduced between January 1998 and August
1998. Intense research was conducted to review immunization legislation from
the Internet. The Legislative Update is intended to inform you about laws in
your state, as well as provide information about laws in other states which may
serve as a model for potential legislation in your state. For more information
about any of the bills discussed, please contact Deborah Alfano, Merck Vaccine
Division, (215) 652-7941.
ADMINISTRATION DATA HAEMOPHILUS INFLUENZAE TYPE B (HIB) HEPATITIS
IMMUNIZATION REQUIREMENTS INSURANCE-RELATED VARICELLA OTHER ADMINISTRATION
Delaware S.B. 339
(Signed by governor)
This act enables pharmacists to administer adult immunizations and
injectable medications, and to perform and interpret capillary blood tests,
pursuant to a valid prescription or physician-approved standing orders or
protocol. The Board of Pharmacy shall establish requirements that pharmacists
must meet in order to administer injectable adult immunizations, biologicals
and medications. A pharmacist may perform capillary blood tests and interpret
the results as a means to detect or monitor disease risk factors, facilitate
patient education or monitor drug therapy.
Georgia S.B. 20
(Signed by governor)
This measure authorizes physician assistants and nurse practitioners to
possess vaccines. A practitioner of the healing arts, in conformity with Code
Section 43-34-26.1, may delegate to a nurse or a physician's assistant the
authority to possess vaccines and other such drugs as specified by the
practitioner for adverse reactions to those vaccines, and a nurse or
physician's assistant may possess such drugs pursuant to that delegation.
DATA
California S.B. 2222
(Pending)
This bill would authorize local health departments and the State
Department of Health Services to disclose certain immunization information to
schools, child care facilities, family child care homes, WIC service providers
and health care plans. The bill would provide that health care providers, local
health departments, the Department, and certain persons or entities authorized
to receive the immunization information are subject to existing civil action
and criminal penalties for the wrongful disclosure of the information.
Colorado H.B. 1210
(Signed by governor)
This bill revises provisions relating to the infant immunization tracking
system. It clarifies that health departments may gather immunization
information from doctors, clinics, third-party payors and persons who have
contracted with the state to operate a "comprehensive immunization
tracking system." The bill modifies the existing infant immunization
tracking system by authorizing health departments to also gather immunization
information from schools, parents of infants, children, students and managed
care organizations in which a child, student or infant is enrolled. The bill further
modifies the existing tracking system by authorizing the release of
immunization records to a child or student, a managed care organization in
which they are enrolled, or a person or entity that has contracted with the
state for the operation of the tracking system. It also allows the use of
electronic files and copies of such files as certification of immunization if
they are provided directly to the school from the central immunization tracking
system. The bill continues to allow the use of paper forms that contain
information transferred from records of a doctor, nurse or public health
official as certificates of immunization.
Hawaii S.B. 2851
(Pending)
This bill states that the department of health may collect and maintain
records of immunizations of children born and living in Hawaii from birth
through age 20, which shall be accessible to health care providers and
departmental programs responsible for providing and promoting complete and
timely immunizations. Information stored in the records system shall be limited
to immunization, demographic and contact information for individuals. No
records may be established for any individual whose parent objects in writing
to the infant's inclusion. Participation in the immunization records system by health
providers is not mandatory.
Maine L.D. 2133
(Pending)
This legislation would establish and maintain an immunization information
system within the state of Maine. By January 1, 1999, the department shall
establish an immunization information system which would require all
immunization providers to submit a record of each immunization administered and
shall adopt rules accordingly. These rules would address: obtaining the consent
of an immunized person before including information about that person in the
system; permitting an immunized person to choose not to include information;
confidentiality of information in the system; and penalties for unauthorized
disclosure of information.
New Hampshire S.B. 379
(Signed by governor)
This enacted legislation establishes an immunization registry within the
Department of Health. This registry would improve the state's ability to
respond to outbreaks of communicable diseases in a manner which reduces the
risk of unnecessary additional immunizations. The Department of Health and
Human Services is directed to ensure that only the minimal amount of medical
information necessary to implement an immunization registry be disclosed, and
that the system be designed to protect the confidentiality of personal
information to the greatest degree consistent with implementing the registry.
Use of information contained in the registry shall be limited to the
appropriate individual representing to the Commissioner that a legitimate need
exists to access the patient's information. The information contained within
the registry will be used to notify registrants of upcoming or missed
immunization, and control/monitor of communicable diseases. The Commissioner
shall adopt rules which address the matter of a patient's confidentiality,
submission of reports and procedures for managed care organizations to obtain
summary statistics. A health care provider will not be allowed to discriminate
against a person due to their choosing not to enroll in the registry. The
legislation took effect on August 14, 1998.
Vermont H.B. 699
(Signed by governor)
This bill establishes a registry within the Department of Health for
childhood immunizations. A health care provider shall report to the department
all data regarding required immunization of children under the age of 18 within
seven days of the immunization. The Department may implement the registry in
any reasonable manner, including establishment of the statewide registry by
incrementally creating local registries in specified geographical areas of the
state on a schedule to be determined by the Department.
Washington H.B. 3028
(Pending)
This proposed legislation relates to the collection and monitoring of
immunization data. This bill states that all health plans that document the
individual immunization status of children immunized within the plan's service
area, and monitor longitudinally the immunization status of individual
children, shall require immunization providers to notify the parent or legal
guardian of each child immunized within the plan's service are that the
immunization status of each child will be reported to and monitored through the
plan and shall offer the parent or legal guardian the opportunity to exclude
their child from this reporting process. Providers may not transmit health care
information to local healthcare jurisdictions for the purpose of monitoring the
status of patients without first obtaining the written permission of each
patient.
HAEMOPHILUS INFLUENZAE TYPE B (HIB)
Oklahoma S.B. 1239
(Signed by governor)
This bill would require a haemophilus influenzae type B (HIB) vaccination
for a child to attend school. The Department of Education and the governing
boards of school districts would be required to provide for release to the
Oklahoma Health Care Authority of the immunization records of school children
covered under Title XIX or XXI of the federal Social Security Act. Such
information would be required to be transmitted to the authority to medical
providers who provide services to such children in an effort to assist in their
efforts to increase the rate of childhood immunization pursuant to the
requirements of the Early and Periodic Screening, Diagnosis and Treatment
(ESPDT) services provisions. The bill is effective as of November 1, 1998.
HEPATITIS
Indiana H.B. 1235
(Signed by governor)
This legislation would require the immunization of children against
hepatitis B. It would require every child residing in Indiana who has not
completed grade one before July 1, 1999, to be immunized against hepatitis B. Schools
would be required to add hepatitis B information to the annual immunization
report the school must file with state and local health authorities.
Iowa S.F. 2341
(Signed by governor)
This legislation would require the Department of Public Health to
develop, and submit to the governor and general assembly by October 1, 1998, a
plan for protecting persons against hepatitis B and requiring children to be
immunized against hepatitis B. Evidence of hepatitis B immunization would be
required for a child born on or after July 1, 1994, prior to school enrollment
in kindergarten or in any grade level.
Michigan H.B. 5817
(Signed by governor)
This legislation would create a hepatitis A immunization program for
certain communities. This bill would not take effect unless H.B. 5820 of the
89th Legislature is enacted into law.
Minnesota S.F. 2372
(Signed by governor)
This bill requires students to receive hepatitis B immunization in order
to enroll or remain enrolled in school.
Missouri H.B. 1419
(Signed by governor)
This legislation requires the testing and vaccination for hepatitis B for
certain pregnant women. It would require the prenatal blood testing of pregnant
women to screen for hepatitis B. If a mother tests positive for hepatitis B,
the physician or person who professionally undertakes the pediatric care of a
newborn shall also administer the appropriate doses of hepatitis B, or HBIG,
within 12 hours of birth to infants who are hepatitis B positive. If the
results of such tests are unknown within 12 hours, the hepatitis B vaccine and
gammaglobulin specific for hepatitis B, HBIG, shall be administered as soon as
possible. No one will be denied testing by the Department of Health because of
inability to pay.
Ohio S.B. 153
(Signed by governor)
This bill requires, with certain exceptions, that all children who begin
kindergarten during or after the school year beginning 1999, be immunized
against hepatitis B. The bill specifies that no child will be allowed to remain
in school for fourteen days unless the pupil can present to the school
administrator of admissions, written evidence of his/her immunization status.
Exceptions to this directive include a physician's certification that such immunization
is medically contraindicated.
IMMUNIZATION REQUIREMENTS
Georgia H.B. 1072
(Did not pass)
This bill concerns immunization requirements for the pre enrollment of
two-year olds. Each local board of education would establish procedures to
provide for the pre enrollment of children at two years of age. Such procedures
would include a requirement that the child submit to the local board or to a
school within the school system a certificate of immunization which indicates
compliance with age-specific immunizations. The Department of Human Resources
would promulgate rules and regulations specifying those diseases against which
immunization is required and the standards for such immunizations.
New Mexico H.B. 402
(Signed by governor)
This proposed legislation would make changes concerning the state's
immunization requirements. The bill states that immunizations required and the
manner and frequency of their administration shall conform to recommendations
of the advisory committee on immunization practices of the US Department of
Health and Human Services and the American Academy of Pediatrics. The
Department of Health shall undertake every effort to obtain federal funding to
implement the department's immunization program.
Rhode Island H.B. 7199
(Signed by governor)
This legislation would require all children, prior to enrollment in
either a public or private school, be vaccinated against such diseases
regulated by the Department of Health. This will include testing for
tuberculosis. Every child more than two years old will be eligible to receive
the immunization against meningococcal disease. The Department of Health will
include the meningococcal disease in its immunization program. This bill took
effect on September 1, 1998.
INSURANCE-RELATED
Delaware S. B. 156
(Signed by governor)
All group and blanket health insurance policies which are delivered or
issued in this State by any health insurer or health service corporation shall
provide coverage for each child of the insured, from birth through 18 years of
age for immunization against: diphtheria; hepatitis B; measles; mumps;
pertussis; polio; rubella; tetanus; varicella; haemophilus B; and hepatitis A;
and any other immunization subsequently required for children by the Secretary
of Health and Social Services.
Indiana S.B. 19
(Signed by governor)
This legislation would provide health insurance coverage to uninsured
children in the state. The office of the children's health insurance program
would be created within the office of the secretary of family and social
services to obtain health services for eligible children. The office would be
required to establish performance criteria and evaluation measures for
providers and provide health insurance coverage for well-baby and well-child
care, including age appropriate immunizations.
Nebraska L.B. 1063
(Signed by governor)
This bill establishes provisions for the children's health care program.
The bill clarifies provisions relating to the exchange of immunization information
between professionals, facilities and departments. North Carolina S.B. 2
(Signed by governor) This bill establishes a children's health insurance
program. On the issue of cost-sharing, it states: Five dollars per child for
each visit to a provider. No copayments required for well-baby, well-child or
age appropriate immunization services.
Utah H.B. 137
(Signed by governor)
This bill creates the Children's Health Insurance Program. It requires
the Utah Department of Health to make rules regarding cost-sharing requirements
for enrollees. These requirements may not impose deductible, copayment or
coinsurance requirements on an enrollee for well-child, well-baby and
immunization.
Virginia S.B. 715
This bill would require health insurers, health maintenance organizations
(HMOs) and corporations providing health care coverage subscriptions contracts
to provide coverage for childhood immunizations. The required benefits apply to
children from birth to 36 months of age, and extend to all routine and necessary
immunizations including diphtheria, pertussis, tetanus, polio, hepatitis B,
measles, mumps, rubella, and other such immunizations as may be prescribed by
the Commissioner of Health.
VARICELLA
Connecticut H.B. 5631
(Legislation dropped - introduced by regulation)
This legislation would require that school age children be vaccinated
against chicken pox and hepatitis B. Governing school boards will require each
child to be protected by adequate immunization against diphtheria, pertussis,
tetanus, poliomyelitis, measles, mumps, chicken pox, rubella, haemophilus
influenzae type B, hepatitis B and any other vaccine required by the schedule
for active immunization being permitted to enroll in any public or nonpublic
school. Before being permitted to enter seventh grade, a child shall receive a
second immunization against measles.
New York A.B. 11239/ S.B. 7649
(Passed, but due to a technical error in the process it will be reintroduced in
1999.)
This bill would require children entering any public, private or
parochial child caring center, day nursery, day care agency, nursery school,
kindergarten, elementary, intermediate or secondary school to be immunized
against varicella (chickenpox) prior to entry. This act shall take effect upon
enactment, and shall apply only to children born on or after January 1, 1997,
beginning with their enrollment in any public, private or parochial
kindergarten, elementary, intermediate or secondary school; and January 1, 1999
beginning with their enrollment in any school.
Oklahoma S.B. 887
(Signed by governor)
This bill would expand the list of immunizations required for children to
include varicella. The State Board of Health would be authorized, by rule, to alter
the list of required immunizations and would require legislative approval of
any changes. An effective date of November 1, 1998 is given for this bill.
OTHER
New York S.B. 240
(Pending)
This bill would provide that no public assistance benefits shall be given
to any applicant or recipient of public assistance who cannot provide
documentation to the local social services district that his or her dependent
children have been properly immunized in accordance with a schedule regarding
age-appropriate immunizations for children as provided by the Department of
Health.
Puerto Rico P.C. 240
(Signed by governor)
This act establishes April 18th of every year as a National Day for
General Vaccinations. It takes effect upon enactment.
THIS IEAC LEGISLATIVE UPDATE IS SUPPORTED BY THE MERCK VACCINE DIVISION.
Sources: Scott Levin, Stateline, State Web site Working to improve the health
of mothers, babies and families.
National
Healthy Mothers, Healthy Babies Coalition 121 North Washington St. Suite
300 Alexandria, VA 22314 Tel: 703-836-6110 Fax: 703-836-3470
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ALL
INFORMATION, DATA, AND MATERIAL CONTAINED, PRESENTED, OR PROVIDED HERE IS FOR
GENERAL INFORMATION PURPOSES ONLY AND IS NOT TO BE CONSTRUED AS REFLECTING THE
KNOWLEDGE OR OPINIONS OF THE PUBLISHER, AND IS NOT TO BE CONSTRUED OR INTENDED
AS PROVIDING MEDICAL OR LEGAL ADVICE. THE DECISION WHETHER OR NOT TO
VACCINATE IS AN IMPORTANT AND COMPLEX ISSUE AND SHOULD BE MADE BY YOU, AND YOU
ALONE, IN CONSULTATION WITH YOUR HEALTH CARE PROVIDER.